血清VitD水平与老年充血性心力衰竭的相关性研究

发布时间：2018-05-25 15:28

本文选题：充血性心力衰竭 + 血清25-羟基VitD3　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:探讨充血性心力衰竭(CHF)患者血清25-羟基VitD(25-(OH)D3)水平与血清脑钠肽(BNP)、LVEF的关系。方法:选择126例CHF患者,测定其LVEF、血清25-(OH)D3、BNP水平。再依据NYHA分级标准进行分级,比较不同NYHA分级患者LVEF、25-(OH)D3及BNP的水平差异,分析25-(OH)D3与LVEF、BNP的相关性。且选30例我院查体健康者作为健康对照组,进行基线对比及LVEF、25-(OH)D3及BNP水平的比较;对心衰组病人进行6个月随访,以心脏不良事件再入院进行分组进行25-(OH)D3水平的比较.结果:基线比较,心衰组和对照组男女性别比例、年龄、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)水平无显著差异;与健康对照组比较,心衰组血清中的BNP水平显著高于正常水平,BNP的水平随着NYHA分级的逐渐增高而数值增加,呈正相关关系,两两比较显示出各不同分级组间比较均存在统计学意义(q=8.12~41.61,P0.05)。随着慢性心力衰竭患者心功能分级的提高,血清25-(OH)D3水平呈现逐渐降低的趋势,两两比较显示出各不同分级组间比较均存在统计学意义(q=3.37~14.07,P0.05);与健康对照组比较,心衰组血清中的BNP水平显著高于正常水平;25-(OH)D3与LVEF低于正常水平(P均0.05);126例CHF患者血清中25-(OH)D3、LVEF水平随着NYHA分级的增加而降低(P0.01);BNP水平随着NYHA分级的增加而增高(P0.01)。血浆测BNP浓度与25-(OH)D3呈负相关(r=-0.585,P0.01);对心衰患者出院后进行为期6个月的随访,根据出现因心脏事件再入院的患者分为未发生心脏事件和发生心脏事件再入院率与血清25-(OH)D3水平的关系进行比较,结果表明:发生心脏事件组患者血清中的25-(OH)D3水平显著低于未发生心脏事件组(P0.01)。在本次研究中,不同的NYHA分级患者25-(OH)D3的水平随着NYHA分级的增加呈递减趋势,观察组血清25-(OH)D3水平明显低于对照组,与相关文献描述一致。所以我们在临床上可以得出,检测25-(OH)D3的水平可以客观的直接的反应出心力衰竭患者心功能的高低好坏,甚至可以作为我们对心衰患者终末期病情的转归的一种评定标准。结论:CHF患者心力衰竭严重程度与血清25-(OH)D3水平有关,血清25-(OH)D3水平可以作为其观察指标。
[Abstract]:Objective: to investigate the relationship between serum 25-hydroxyVitD (25-OH) D 3) and serum BNPP LVEF in patients with congestive heart failure (CHF). Methods: LVEF and serum 25-OHH D 3 BNP levels were measured in 126 patients with CHF. Then according to the NYHA classification standard, the differences of LVEF25-OHH3 and BNP levels in patients with different NYHA grading were compared, and the correlation between 25-(OH)D3 and LVEFNP-BNP was analyzed. There was a negative correlation between plasma BNP concentration and 25-(OH)D3. The patients with heart failure were followed up for 6 months after discharge. According to the patients who had readmission due to cardiac events, the relationship between the readmission rate of no cardiac events and the level of serum 25-(OH)D3 was compared. The results showed that the level of 25-(OH)D3 in the patients with cardiac events was significantly lower than that in the patients without cardiac events (P 0.01). Conclusion the severity of heart failure is related to the level of serum 25-(OH)D3, and the level of serum 25-(OH)D3 can be used as an index.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.6

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